Chairman Mao was a chainsmoker, one of an estimated 56 per cent of Chinese men who smoke, helping to consume 750 billion cigarettes every year. The Chinese appetite for tobacco doubled the country’s rate of lung cancer between 1963 and 1975, pushing deaths from smoking higher even than those in much of the industrialised world.

Smoking is just one of the man-induced afflictions singled out by the President of the World Health Assembly, Chong Hon Nyan. Nyan, who is Malaysia’s Minister of Health, warns that problems ‘once thought of as being the by-products of affluence are now beginning to take their toll of the health of people in the Third World too.

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According to President Nyan, we are witnessing the emergence of a new set of communicable diseases, every bit as deadly as the old familiar killers like malaria, cholera, tubercolosis and leprosy. But these new diseases — such as smoking, alcoholism, heart disease — are communicated, not through parasitic or bacterial infection, but by imitation. And that means they can spread fast and far: ‘as fast as communications can speed images from one country to another’, says President Nyan.

The World Health Organisation (WHOI calls smoking ‘the most unnecessary of modern epidemics’ and estimates that every year at least one million people go early to their graves as a result of the habit. The new epidemic, fostered by advertising and rapid urbanisation, is spreading fastest in developing countries, with cigarette consumption increasing at over three times the rate of that in the rich world.

Every person in India, for example, puffs their way through an average of 190 commercial cigarettes and 1,500 bidis (traditional hand-rolled cigarettes) a year —an increase of nearly 100 per cent compared to 20 years ago. In Pakistan, consumption has nearly doubled in just ten years and is currently increasing at a rate of six per cent a year. In Kenya too, and Malaysia, consumption is currently increasing at between six and eight per cent a year.

And, along with the consumption, come the consequences. By 1960 20 per cent of deaths in Latin American cities were already being caused by smoking; lung cancer has become the most common form of cancer in the Philippines and is predicted soon to be killing at a rate of 12,000 a year in Bangladesh. And these disease rates are just the tip of the iceberg. Consumption of cigarettes is storing up a terrible burden that will sink onto the shoulders of the developing world’s struggling health services around the turn of the century as the new smokers of today become the cancer, bronchitis and heart disease cases of tomorrow.

Another major communicable disease epidemic in the developing world is alcoholism. Classifying alcohol as among the world’s major public health concerns that threatens to overwhelm the health services’, WHO comments that drinking is encouraged by ‘commercial interests of a massive and influential kind’.

Between 1960 and 1972, for example, recorded production of alcohol increased by 19 per cent for wine, 68 per cent for beer and 61 per cent for spirits. According to WHO this increase is largely due to people of different countries ‘catching’ the drinking habits of another region and adding them to their own. This drinking ‘infection’ spreads fastest in countries undergoing rapid social and cultural change which tends to undermine traditional drinking patterns. In much of Africa, for example, people used to limit their alcohol consumption largely to beer made from excess grain and consumed around harvest time. Today beer is bought in tins and consumed the whole year-round.

WHO estimates that in many countries between one and ten per cent of the entire population can be classified as either ‘heavy drinkers’ or ‘alcoholics’. The health consequences can be horrific. Cirrhosis —a degenerative disease that kills by destroying liver function — is in the top five leading causes of death among adults in several developing countries. Between a third and a half of all fatal road accidents involve alcohol, which is also implicated in nearly a third of industrial accidents. Half of admissions to psychiatric services in Argentina are for alcohol-related problems. Comments WHO: ‘These problems are now affecting the health, welfare and safety of total populations and, according to reports from some countries, even national development’.

A third scourge of the rich world, now poised to wreak havoc in developing countries, is heart disease. Top killers in the industrialised world — responsible for up to 50 per cent of all deaths — diseases of the heart and circulatory system are caused by a variety of factors related to changes in lifestyle since industrialisation — like smoking, change in diet, stress and obesity.

But these unhealthy habits are just symptoms of a more general malaise of a world system that tends to put the health of balance sheets before the health of the people. Hatfdan Mahler, Director General of the WHO, calls this the ‘social pathology that comes from an aggressive consumer society’. Untrammelled economic progress — bringing rapid growth in agriculture as well as industry — brings new lifestyles and new hazards that claw back the health benefits of higher living standards.

This article is from
the September 1983 issue
of New Internationalist.
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